Provider Demographics
NPI:1346611290
Name:FOSTER, TASHA NAKI
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:NAKI
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4609
Mailing Address - Country:US
Mailing Address - Phone:316-444-3762
Mailing Address - Fax:316-854-5356
Practice Address - Street 1:2606 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4609
Practice Address - Country:US
Practice Address - Phone:316-444-3762
Practice Address - Fax:316-854-5356
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087183163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health